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PostPosted: Wed Dec 19, 2012 10:37 pm 
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happy to be back on suboxone after i had a nasty relapse post having a shoulder arthroscopy first time i was on i think i was tapered off too fast only about 3 months of using suboxone. now i found a great doctor who agreed to keep me on it for as long as i need to be however i think i am one of those people who will need to be on suboxone for life in order to feel normal and prevent another relapse who else feels on this boat. also i just was inducted again thats why i am posting here they started me on subutex first which is great because last time i went straight to suboxone and didnt wait too long so i got really sick :(


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PostPosted: Thu Dec 20, 2012 12:56 am 
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WELL
that's all REALLY GOOD NEWS, isn't it????

You should be PROUD of yourself for REACHING OUT for help, after a relapse..... You know, many of "us" addicts
are too ashamed to ask for help once again, after a relapse, and the results are never great.

so be proud of yourself, for that.

besides suboxone are you thinking about doing any counseling or anything like that???

it's always good to try and get to the "root" of why we ever used in the first place....Im not trying to preach,
and I certainly dont know EVERYTHING.........
no expert here!!!
:wink:
Counseling has just really opened alot of doors for me,,,
I've been on suboxone now just short of two years,,,,
this will be SECOND christmas, off the pills!!!
anyways,,,,
here's a link to a blog post I really like by the suboxdoc, about how long people should remain on suboxone,,,,
well maybe I'll just copy/paste the article!!!
have a great night/day and
[marq=right]~~~welcome~~~[/marq]

LINK
http://www.suboxonetalkzone.com/why-do- ... enorphine/



Suboxone Talk Zone: A Suboxone Blog

Questions and Answers about Opioid Dependence and Buprenorphine





Why do some docs kick patients off buprenorphine?

by J T Junig on September 7, 2010






I often receive e-mails from people that go something like this: I was addicted to oxycodone and heroin for 5 years, and lost my marriage, several jobs, and the trust of my children. I was completely broke, and considering suicide. Then I heard about treatment with buprenorphine and found a doc who prescribed it. Since then everything has been going much better; I have a job, I’m putting some savings away, and I have been starting to reconcile with my family. But my doctor says he wants me off Suboxone and is making me taper, and I’m definitely not ready. I am starting to panic because I know that if I have to go off buprenorphine I’ll only end up using again. Is there a way to make him keep me on buprenorphine?

I have described my approach ad nauseum on this blog. I look at the ‘givens’:

- Despite everyone’s wish that addicts stop using opioids and ‘get off everything,’ it just doesn’t work that way. The relapse rate after stopping opioids is very high, whether stopping buprenorphine or any other opioid substance.

- Opioid dependence is a chronic illness that never goes away. People relapse even after years of sobriety.

- Traditional treatment suffers from very high costs and very low success rates, and requires a large time commitment. Traditional treatment does NOT offer any ‘long term protection’ against relapse; if a person stops attending meetings, the rate of relapse becomes similar to those who never went through treatment.

- Buprenorphine can hold opioid dependence in remission in motivated addicts. It is not just a ‘substitution’ of one drug for another, as the ‘obsession’ which is the essence of addiction is reduced, allowing personality to improve and for other interests to return.

- The side effects and risks of taking buprenorphine are not significant, especially when compared with treatments for other life-threatening conditions.



- Even a short relapse can have unpredictably severe consequences, including legal trouble, loss of career, loss of key relationships, and death.

I could go on and on with this list, but you get the idea. My own conclusion then has been that buprenorphine should be considered a long-term treatment for a long-term condition.

Why do some doctors insist on a short-term approach? One reason is simple ignorance, and not understanding the nature of opioid addiction. Many docs persist in seeing addiction as a ‘choice’, and fall into the same silly thinking that some addicts initially believe, that the main barrier to sobriety is withdrawal. Addicts who become miserable enough to get through withdrawal quickly learn that the withdrawal is NOT the problem—at least not the MAIN problem—as even after the symptoms go away, the addict relapses. This is maddening to the addict’s loved ones, and some doctors see this situation and become angry at the addict, rather than understanding the nature of addiction. At least there are now studies showing the high rate of relapse, and hopefully the data will change the behavior of physicians prescribing buprenorphine.

Another reason for short-term prescribing is because the buprenorphine is being used as detox, for entry into a ‘total sobriety’ treatment center. I won’t get too upset about such a situation, except to point out that such treatment centers commonly mislead patients about their chances. At the treatment center where I used to work, Nova counseling services in Oshkosh, WI, the counselors would get very excited about patients who looked good on their way out the door. But nobody seemed to feel any responsibility if that same patient relapsed and returned—or died—six months down the line. Of course many patients never made it to the end of treatment, getting thrown out early or leaving on their own. The counselors blamed those failures on the patient—instead of recognizing a failing treatment strategy. THIS IS A VERY SERIOUS PROBLEM, by the way, with residential, traditional treatment programs—a problem that exists because of stigma about addiction, and a sense that addicts are less deserving of good health than ‘normal people.’ How can I say that? Think of it this way—what if any other illness was managed in this way? If heart disease or diabetes simply failed to make people better most of the time, and the doctors routinely blamed the patients for the lack of success, how would THAT fly?

My biggest concern is that there are motivations to get patients off buprenorphine that come from the requirements placed on physicians who prescribe the medication. Physicians can treat only 30 patients at a time with buprenorphine. After a year they can apply to raise that limit to 100 patients. Ironically there is no limit at all on the number of patients a doctor can treat with opioid agonists! In a typical practice, patients are seen less often as they become more ‘stable’ on buprenorphine, resulting in a situation like mine– I have about 100 patients who have done well on buprenorphine for some time, many of whom had multiple attempts at ‘traditional treatment’ and some who were on buprenorphine from other docs, who would like to stay on buprenorphine long-term. That’s fine with me; buprenorphine patients are a small part of my practice. But if I wanted to make significant income from patients on buprenorphine, I would need to clear out spots for new patients who are seen at greater frequency, and who would pay the initial intake fee.

In other words, doctors are rewarded for high patient turnover, and the growth and earning power of their practices are limited by the cap on the number of patients they can treat. I understand the reason for the cap; we don’t want to suddenly have thousands of patients on buprenorphine without adequate treatment and supervision. But there is always a downside to any regulation, and rapid turnover in some practices is a downside to this particular regulation.

I don’t have any particular advice for people who are being forced off buprenorphine for no fault of their own, other than to seek out a new physician. Patients who are considering starting buprenorphine may want to ask the doctors in their area about their attitudes toward long-term maintenance. Hopefully over time at least some of the motivations for pushing people off buprenorphine will become less significant. For the docs who are doing the pushing, I encourage you to examine your own motivations. I realize that everybody wants to get back to how they were before becoming addicted to opioids… but it is important to remember that nobody can predict the outcome of a relapse, and some people die.
..
Read more at http://www.suboxonetalkzone.com/why-do- ... rkllylR.99

_________________
anyone can give up,
its the easiest thing in the world to do, but to
hold it together, when everyone would understand if you fell apart
That's TRUE STRENGTH
http://almostoneyearclean.blogspot.com/


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PostPosted: Thu Dec 20, 2012 2:00 am 
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thanks once again for the great reply of information! i enjoyed that article and many things on there i didnt even know and to me it sounds like of bunch of bs with those limits he was talking about! anyway i found this site from the suboxdocs youtube channel and really enjoy it ill continue to talk to you guys about my progress and i think to answer your question about counseling is that i am open for it my new suboxone doctor said he will help set me up with someone he knows that specializes in addiction soon i am looking forward to it. in the past i went to NA with a friend i didnt really love it but i didnbt hate it i believe it is a total drug free program right? anyway most of the people there were court mandated and were in trouble with the law thank god for myself i was never in trouble with the law from my addiction i was very lucky i sought help on my own


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PostPosted: Thu Dec 20, 2012 1:20 pm 
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I was on subs for 3 years then I tapered off and stayed off of subs for a year and a half but then I had my usual cravings come back and I was back on opiates. I am now as of last month also back on subs. I plan on staying on them this time forever. I know that without a lot of support or counseling I will always go back to opiates. But... with subs, the cravings are gone and why not stay on them forever. If you have a doctor willing to subscribe to your for as long as you need, I would personally stay on them. Its like treating a disease or depression. You would continue your meds then right? As long as I can afford the subs and the doctor, I see no problem being on them if they make me a better person and off opiates then I will be on them a lifetime.


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PostPosted: Thu Dec 20, 2012 4:12 pm 
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This is just my personal view on this but when you start suboxone the last thing you should want or say is i want to be on this crap for life.

Dont you want to know what its like to truly be 100% clean and sober. Saying you want to take it for life is almost the easy way out besides suboxone was not intended ti be a long term drug. I just think our true goal is to use it as a tool to one day be able to live and not need any drugs to get through the day.

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Yes these drugs saved our life's. But does that mean we have to give the rest of our life to these drugs?


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PostPosted: Thu Dec 20, 2012 4:28 pm 
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the thought of being completely clean does appeal to me i wish i could do it but at this point im not going to tolerate being rushed off it again because the only bthing thats going to happen is im gonna run back to the reall thing because thats my preference i also use opiates for anxiety and i discovered they help me in ways xanax and other psych meds do not so that only added to my dependence im not about to call it quits anytime soon with suboxone since its helpiing me but thanks fr your input guys!


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PostPosted: Fri Dec 21, 2012 12:39 am 
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onsubs89 wrote:
the thought of being completely clean does appeal to me i wish i could do it but at this point im not going to tolerate being rushed off it again because the only bthing thats going to happen is im gonna run back to the reall thing because thats my preference i also use opiates for anxiety and i discovered they help me in ways xanax and other psych meds do not so that only added to my dependence im not about to call it quits anytime soon with suboxone since its helpiing me but thanks fr your input guys!




I can see where your coming from,,,

ESPECIALLY AFTER a bad relapse..... I think Bboy is mostly pointing out for people who are starting suboxone,for the
first time, EVER.
Or ,
at least I THINK That's what he means......LOL
but who knows........

you have already been around the block so-to-say and KNOW what's in store for YOU, when your rushed off,
as you put it.

Keep on truckin' your doing great. and IM GLAD you've found all the information here useful/helpful.
Nice to be informed, eh?
:wink:

_________________
anyone can give up,
its the easiest thing in the world to do, but to
hold it together, when everyone would understand if you fell apart
That's TRUE STRENGTH
http://almostoneyearclean.blogspot.com/


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PostPosted: Fri Dec 21, 2012 1:15 am 
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Although I understand where Bboy is coming from, not everyone is going to have the goal of being 100% off opiates. I think the biggest goal of people is to live a good, happy life with their family. If the only way to achieve that happiness is by taking a medication that includes opiods, then being on it long term might make sense. This is especially the case for people who have terrible anxiety or depression that the sub alleviates.

Bboy is right, I think, about not having long term use be your goal if you're just starting out on sub. You have some good experience with this medication though and you know what your life is like without it.

I think I'm a pretty good candidate for tapering off sub and being fairly successful. I'm taking it slow, but I am tapering. But for some folks, the "easy" way out is the only way out, and I respect that too.

Amy

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PostPosted: Fri Dec 21, 2012 1:41 am 
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i mglad you guys saw where i was coming but i also understood the other guy too but yeah like u guys said all would go to shit if i got off it again like i did last time and i am not trying to be a negative nancy i am positive and i am motivated im just as u said happy with life on suboxone which happens to be a legal opiate supplement that works for me and ill be damned if i let that go or be pressured into haha its kind of an obession because i hate feeling like shit and craving but shit dont we all!


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PostPosted: Fri Dec 21, 2012 1:45 am 
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o and i meant pressured to get off it by the doctor since obviously hes the authority behind my script


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PostPosted: Fri Dec 21, 2012 11:44 am 
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I am not afraid to say that I want to be on suboxone the rest of my life. I have tapered off once before and took no subs and I just wanted to do drugs again. So for me... I will take it forever.


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PostPosted: Sat Dec 22, 2012 5:15 pm 
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January will be the two-year mark for my Suboxone maintenance. I've learned a lot about the difference between dependence and addiction over the past year, and did some very deep reflecting. Knowing everything I know now, I really have no desire to stop because I know that it was more than coincidence that got me here. Since I started Suboxone, my life has been so much better (well, in this particular regard).


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PostPosted: Sat Dec 22, 2012 10:15 pm 
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i would agree with those of u who dont plan on getting off it either because i know i am gonna wanna use immediately after i stop suboxne again i know it cus ive been there before as soon as the subs stop the withdrawals start and the cravings return ruthlessly and i really dont believe any therapist or na meeting in the world will change that i am also a believer in god and i know that even he wants me to make good use of suboxone because it helps me to be a better person those r my personal beliefs but u guys get the picture


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PostPosted: Sun Dec 23, 2012 5:16 am 
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onsubs89,

I agree with what you are saying. If you feel you want to be on sub forever then good for you!

I mean no disrespect to Bboy but I do disagree with him.

It seems like in 2012 we should have a progressive attitude toward addiction. Being completely drug free may not be the best option for some people. And that should be ok! The goal of treatment should be to stop the destructive cycle of drug abuse/addiction and improve livrs. To enjoy our families and help others. To work for our money and be responsible members of society. If a person is doing all that why the fuck does it matter if he/she takes a prescribed medication?

And what about the addict with chronic pain? Should he/she suffer for the sake of some idea that being clean is the goal?

Im just tired of having to defend my sub use to many people in the addiction community who think its the easy way out. That I am not clean. That I am not as in recovery as they are.

The ultimate goal for recovery should be that the addict stays alive and makes positive forward progress. If sub is a way to accomplish it, then people should celebrate it!


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PostPosted: Sun Dec 23, 2012 7:13 pm 
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yes u r totally right however i respect people like the other guy who can do it without opiod replacement wish i could it would be cheaper than buying painkillers or suboxone but what the hell who cares im able to begin the steps of putting my life back together like getting a new job going back to my college and so forth im 23 and i got a long life ahead of me god willing hope to get the ball rolling!


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Fond Du Lac Psychiatry
Dr. Jeffrey Junig, M.D., Ph.D.

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